CMS Formulary

Displaying 27721-27730 of 1611142 results.
ID: 27721
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1939299
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 27722
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1939348
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 27723
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 577324
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27724
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 727316
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 27725
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870207
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 27726
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1374574
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 224
Qty Limit Days: 28
ID: 27727
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2003255
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27728
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2198370
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 27729
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 865208
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 27730
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 865212
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30